Background: Diastolic wall strain (DWS), defined using posterior wall thickness (PWT) measurements from standard echocardiographic images (DWS = [PWT(systole)-PWT(diastole)]/PWT(systole)), has been proposed as a marker of left ventricular (LV) diastolic stiffness. However, the equation for DWS is closely related to systolic radial strain, and whether DWS is associated with abnormal cardiac mechanics (reduced systolic strains and diastolic tissue velocities) is unknown. We sought to determine the relationship between DWS and systolic and diastolic cardiac mechanics.

Methods: We calculated DWS and performed speckle-tracking analysis in a large population- and family-based study (Hypertension Genetic Epidemiology Network [HyperGEN]; N=1907 after excluding patients with ejection fraction [EF] <50% or posterior wall motion abnormalities). We measured global longitudinal, circumferential, and radial strain (GLS, GCS, and GRS, respectively) and early diastolic (e') tissue velocities, and we determined the independent association of DWS with cardiac mechanics using linear mixed effects models to account for relatedness among study participants. We also prospectively performed receiver-operating characteristic (ROC) analysis of DWS for the detection of abnormal cardiac mechanics in a separate, prospective validation study (N=35).

Conclusions: DWS, a simple parameter than can be calculated from routine 2D echocardiography, is closely associated with systolic strain parameters and early diastolic (e') tissue velocities but not LV chamber compliance.

Mentions:
Figures 1 and2 show the relationship between DWS quintiles and LV strain parameters and diastolic indices, respectively. Table 3 demonstrates the correlation between DWS and both 2D and speckle-tracking echocardiographic systolic and diastolic indices. There was a modest but significant correlation between DWS and many systolic and diastolic indices. The strongest correlation was with midwall fractional shortening, a systolic index (R = 0.56, P < 0.001). DWS did not correlate with EF. Importantly, DWS did not correlate with measures of LV chamber compliance (EDV20 and early mitral inflow [E] deceleration time).Figure 1

Mentions:
Figures 1 and2 show the relationship between DWS quintiles and LV strain parameters and diastolic indices, respectively. Table 3 demonstrates the correlation between DWS and both 2D and speckle-tracking echocardiographic systolic and diastolic indices. There was a modest but significant correlation between DWS and many systolic and diastolic indices. The strongest correlation was with midwall fractional shortening, a systolic index (R = 0.56, P < 0.001). DWS did not correlate with EF. Importantly, DWS did not correlate with measures of LV chamber compliance (EDV20 and early mitral inflow [E] deceleration time).Figure 1

Background: Diastolic wall strain (DWS), defined using posterior wall thickness (PWT) measurements from standard echocardiographic images (DWS = [PWT(systole)-PWT(diastole)]/PWT(systole)), has been proposed as a marker of left ventricular (LV) diastolic stiffness. However, the equation for DWS is closely related to systolic radial strain, and whether DWS is associated with abnormal cardiac mechanics (reduced systolic strains and diastolic tissue velocities) is unknown. We sought to determine the relationship between DWS and systolic and diastolic cardiac mechanics.

Methods: We calculated DWS and performed speckle-tracking analysis in a large population- and family-based study (Hypertension Genetic Epidemiology Network [HyperGEN]; N=1907 after excluding patients with ejection fraction [EF] <50% or posterior wall motion abnormalities). We measured global longitudinal, circumferential, and radial strain (GLS, GCS, and GRS, respectively) and early diastolic (e') tissue velocities, and we determined the independent association of DWS with cardiac mechanics using linear mixed effects models to account for relatedness among study participants. We also prospectively performed receiver-operating characteristic (ROC) analysis of DWS for the detection of abnormal cardiac mechanics in a separate, prospective validation study (N=35).

Conclusions: DWS, a simple parameter than can be calculated from routine 2D echocardiography, is closely associated with systolic strain parameters and early diastolic (e') tissue velocities but not LV chamber compliance.